Follow
Share

My mom chose to move there 5 years ago she was still driving. Just a month ago she beat me at scrabble, but something happened when she was in the hospital (because of high BP) she came back totally different. She does have issues, memory, agitation, confusion. etc. She also falls (but that's been the case for the past 40 years, she moves too fast). Last week they told me they needed to put her in hospice (because of her falling, memory, etc. and because her neighbors are 'concerned'). Initially they recommended hospice care for extra attention but didn't mention moving to MC. They told me last Monday that they plan to move her this Friday (less than 2 weeks) I am going to be in NY for 5 days so I won't be here when they move her but they have refused to wait until I get back (they say it's easier if I am not here and that they are doing this for her safety). She is still lucid most of the time (she has sundowners) but I know she will have a fit (they got her a new bed without asking and she's livid about it). I'm an only child, divorced and no kids so no family support system. I'm overwhelmed and just don't have much energy left to fight with them. After NY I have to go to on two business trips through mid-June (I travel and work a-lot). I just need some suggestions as what I can say to make them wait. I haven't signed off on anything yet. Plus initially they told me that Hospice was free but the new MC fee agreement has an additional 'Hospice fee' of $2100/month. I've really liked the place and people since she moved there but this just seems wrong.

How can they get her a new bed w/o your authorization, or move her to memory care w/o your authorization?? You can refuse to PAY the increased fees of $2100 which will stop them dead in their tracks, I'm quite sure, and buy you some time. Medicare pays entirely for hospice, but memory care is significantly more expensive than AL, so I'm guessing the $2100 is for rent, not "hospice". What is the qualifying reason for hospice? As far as I know, "neighborly concern" is not a Medicare approved reason.

On the other hand, mom is 98. At that age, a hospitalization can change her health profile instantly, and cause dementia to go downhill rapidly. 98 with dementia is reason enough for hospice, "Senile Degeneration of the Brain " is the Medicare code. And you do travel a lot. Memory Care provides a lot more care than AL does, I know because my mother went from AL to MC after a hospitalization too.

But, I agreed to it. If you want to hold off on this, make your wishes known as your mom's advocate and the payor of her bills. Unless she's in such immediate danger, and then she should probably go back to the ER for an MRI to see if she's having strokes.

It seems like you should pay eyes on your mom before you'll feel comfy making a decision.

Best of luck advocating for mom.
Helpful Answer (4)
Reply to lealonnie1
Report

They are using Hospice for extra help. IMO they are not authorized to put this in place without your input. They are not authorized to buy Mom a new bed either unless a hospital bed and Medicare pays for that. MC will cost more. Hospice services are paid for by Medicare. You need to be there to see what is going on. Maybe your June trips need to be pushed back. At this point I think Mom is a priority. As said, maybe you can hire someone to make sure Mom is watched over.
Helpful Answer (4)
Reply to JoAnn29
Report

They cannot put your mother in hospice care. As her POA you need to sign authorizations along with her MD. Don’t pay a “hospice” fee. Hospice is paid by Medicare. Expect increased rent and care fees for memory care. Ask the director for an itemized accounting for every charge. As mentioned previously, they should be an advocate for your mother rather than your adversary. Things don’t add up in your scenario so ask questions. Best of luck to you.
Helpful Answer (4)
Reply to RLWG54
Report

Well, your being out of town is fine. Generally, when someone enters MC, due to the radical change in environment, it is recommended family not visit, or visit only very briefly for some few days.

Your profile says your mom is 98. She is apparently now closing in on the end of her life, and she is in need of more care. However, I find the recommendation for Hospice confusing.
A) Hospice itself no longer provides much care at all. A few bedbaths a week, one RN visit a week, a phone call to family from clergy and from Social Worker. That's about it and for that the compensation from medicare is enormous. This has made Hospice the darling of hedgefunds currently. BUT, and however, Hospice is still END OF LIFE CARE, and that needs to be clear. Hospice nursing has access to drugs, and these drugs are meant for comfort for end of life. Hospice is NOT meant to help out caregivers, tho currently MDs fudge stuff a bit to get it in the door.
B) You have been told there is a hospice care fee.
I never heard of such a thing and this is a hefty fee.
WHAT IS IT FOR?
If your mother is requiring a personal aid I get it.
I otherwise do not.

I am sorry you are out of town because I myself would have questions here.
Some things seem to be missing here.
I think a larger discussion is needed with the administration.

I wish you the very best.
Helpful Answer (3)
Reply to AlvaDeer
Report

Thanks everyone I am meeting with them Tuesday morning, and this is so helpful for me to figure out all my questions and not miss something. It's just a gut feeling I have that they are more concerned about money than my mom's safety, so it is good that I have all this input to formulate good questions.
Helpful Answer (3)
Reply to GreenTeaGal
Report

I know you don’t have the time but I would look for her a new place. Hospice services are covered by Medicare.
Perhaps you could hire a care manager to help find her a new place?
This is going to be a big adjustment for your mom either way.
I do understand not having the energy to deal with the facility but all this seems so high handed.

I have not dealt with memory care and others who have may feel differently.
Helpful Answer (2)
Reply to 97yroldmom
Report

If they are doing the move in order to provide the safety she now needs, it may not be a good idea to wait.

You don’t have a family support system. That makes it hard on you. But how about if you could accept the support system that’s available to you - the facility where she lives. Make them your partner, not your adversary. Adopt the attitude that you’re all in this together to help mom.

This is a matter of acceptance of what is rather than what was. You’re fortunate that she’s in a place where she can upgrade to the level of care she needs.
Helpful Answer (2)
Reply to Fawnby
Report

I would ask for a breakdown of the "Hospice Fee"
That seems outrageous and out of line,.
With Hospice the facility CNA will not be doing a bath or shower so that frees up the facility CNA.
With Hospice providing gloves, barrier cream, incontinence briefs, pads and other supplies there is no need for you or the facility to purchase them,
With Hospice the Hospice Doctor will be your mom's doctor not the facility doctor.
With Hospice the Nurse from Hospice will be monitoring mom so there is less the facility nurse has to do. Other than administering meds and there will probably be fewer meds or the same amount of meds not more so the facility nurse is not doing more.
So this added fee seems outrageous.

You can contact the Hospice that will be caring for mom and ask them to ask the facility to wait.
You can also contact ANY Hospice of your choosing and select that Hospice not the one that the facility is suggesting.
Hospice can take mom and place her in "Respite" for the time you are away and then you can be there for the move when you return. That does mean she will be in a Hospice In Patient Unit for a few days.
Hospice could even call the few days in the In Patient Unit "Symptom management" or "Pain management" All would be covered by Medicare or Medicaid with no added cost for the In Patient Unit.
Helpful Answer (2)
Reply to Grandma1954
Report

A physician must order hospice I understand that right now hospice is not being recommended, but the facility can not implement it without a physician's approval, in any case. Also, hospice care is free, but that does not cover room or board. The only way I can understand an additional hospice fee is if they are changing her physical location that is more expensive than her current location.
Helpful Answer (1)
Reply to Igloocar
Report

Ask a Question
Subscribe to
Our Newsletter